A 1994 National Institutes of Health consensus panel recommended that eradication of Helicobacter pylori should be first-line therapy for persons with duodenal ulcer.
To assess the cost-effectiveness of H pylori eradication relative to alternative pharmacologic strategies in the long-term management of persons with confirmed duodenal ulcer.
Duodenal ulcer recurrence at 6 months (symptomatic and asymptomatic) with placebo was 65.4% and 12.8% with maintenance ranitidine therapy.
Where eradication of H pylori was successful (85% of patients), the ulcer recurrence rate to 12 months was 3.7%. Treatment with ranitidine and triple therapy to eradicate H pylori on first presentation has an expected 1-year cost of $253 with 15 symptomatic recurrences per 100 patients ; H pylori eradication by omeprazole plus amoxicillin had similar expected costs ($272) and outcomes (15 recurrences per 100 patients).
Both of these early H pylori eradication strategies were dominant (less costly with same or better outcomes) over intermittent or continuous maintenance ranitidine therapy or delayed (after first recurrence) H pylori eradication.
Our analysis provides economic evidence in support of the recent guidance that for persons with duodenal ulcer, early attempts to eradicate H pylori are recommended.
Mots-clés Pascal : Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Ulcère, Duodénum, Coût, Long terme, Traitement, Complication, Homme, Canada, Amérique du Nord, Amérique, Infection, Bactériose, Appareil digestif pathologie, Intestin pathologie, Economie santé
Mots-clés Pascal anglais : Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Ulcer, Duodenum, Costs, Long term, Treatment, Complication, Human, Canada, North America, America, Infection, Bacteriosis, Digestive diseases, Intestinal disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0571368
Code Inist : 002B05B02F. Création : 01/03/1996.